Laser Surgery in Gynecology

Abstract

The availability of one carbon dioxide laser surgical system, in which the beam can be applied both through the operating microscope (colposcope) for microsurgery and through the articulated handpiece of a so-called laser scalpel for tissue resection or tumor vaporization in major surgical procedures, is very desirable. Most gynecologists manage clinically intraepithelial mucosal lesions of the female genital tract that are of microscopic dimensions, as well as large benign and, to some extent also, malignant tumors. In gynecology departments of universities and large medical centers, subspecialized experts in colposcopy, gynecologic oncology, tubal reconstructive surgery, and conventional gynecologic surgery all may want to apply the laser beam in their sophisticated fields. The option to convert expediently the modus of operation of a surgical carbon dioxide laser from microsurgical application through an operating microscope to a hand-held thermal scalpel, therefore, should be available for all surgical laser models. Some microsurgical carbon dioxide systems, unfortunately, are designed for colposcopy only. In some of these, a short mounting stand prohibits intraabdominal applicability, as for instance in microsurgery on the fallopian tube. In medical centers, surgical lasers should be shared by several departments for cost-efficiency and cross-use if one laser should be out of service.